Fewer than one-third of kids with mental disorders receive treatment, director says

treatment of mental disordersTens of thousands of BC’s young people are experiencing mental health problems every year but fewer than a third of them actually receive treatment. That was the stark message from the Director of SFU’s Children’s Health Policy Centre to the Members of the Legislative Assembly of BC on the Select Standing Committee on Children and Youth.

“About 13 percent of kids are experiencing one or more mental disorders,” said Charlotte Waddell, who also holds the Canada Research Chair in Children’s Health Policy. “That means the total population affected is about 84,000 in BC at any given time, and about 678,000 in Canada. And we’re serving fewer than one-third of them,” she said. That translates to about 26,000 children and youth in BC and 212,000 in Canada.

Waddell presented her evidence to the committee June 11, 2014, when it was meeting in Vancouver as part of a special project examining youth mental health.  Part of the committee’s mandate is to foster greater awareness and understanding of the BC child and youth service system.

In presenting her report, Waddell emphasized that most mental health problems start well before adulthood and, in fact, many start well before adolescence.

In the very early years, autism, anxiety, disruptive behaviours and attention-deficit/hyperactivity disorder emerge. In the middle years, seven to 12, anxiety, depression and conduct disorder begin to appear. Then, in the teen years, substance use, bipolar disorder, eating disorders and schizophrenia can take hold, Waddell said.

“Unspeakable losses and unspeakable severity are what we’re talking about,” she said. “If we don’t intervene and if we don’t intervene effectively these disorders persist, and they carry on throughout adulthood.”

As a result, young people may not finish school and may not even be able to participate in the workforce. They also have increased physical health problems, and “early mortality is significantly increased in people with mental health problems,” she said. The impact on society is also very serious, with costs exceeding $50 billion annually in Canada.

A large part of the problem, Waddell said is that Canada may spend $200 billion annually on health — but little of that goes to children and youth.

“I cannot imagine anyone saying that it was acceptable to have only 30 percent of kids with cancer receiving treatment when we had a host of effective treatments,” Waddell said. “But that’s what we’re doing with mental health problems.”

Waddell concluded by making five recommendations to the committee:

  • Acknowledge that mental disorders start at the beginning of life and provide a comprehensive range of evidence-based interventions at each stage of development, starting in early childhood.
  • Triple investments in evidence-based treatment services to reduce symptoms and impairment among all children and youth with established mental disorders.
  • Make equivalent investments in evidence-based prevention programs to reduce both prevalence and the need for treatment services over time, starting with the four most common preventable disorders (anxiety, substance use, conduct and depressive disorders).
  • Evaluate all treatment services and prevention programs to ensure they are effective.
  • Invest in new data collection to monitor the prevalence of child and youth mental disorders over time.

“Investments in the mental health of young people are among the most important investments that any of us can make,” she told the committee.

A copy of Waddell’s slide show can be seen here. A copy of the report she tabled is available here.